Outsource DME billing

  • DME Billing Services
    Advantages of outsourcing DME billing

    Advantages of outsourcing DME billing

    Administrations of Durable Medical Equipment (DME) can be a tedious and time-consuming task. In addition to other things, it requires inside and out knowledge of reimbursement rules of Medicare, Medicaid and Commercial Plans, and their admonition. It likewise requires consistent adherence to quality and staying side by side of the considerable number of change events in repayment regulations and coding and documentation prerequisites. When you outsource your medical billing operations, the billing team focuses exclusively on the filing of claims, so there is no pressure on them to treat urgent patients or save lives. They take the workload off your back, freeing up your doctors and team to focus on other matters. There are several advantages of outsourcing DME billing, some of the advantages are listed below: More Control: It is a common misconception that by outsourcing your medical billing services you can lose control over your business processes. In fact, many people feel that they have better control over their medical billing processes and the money involved due to a trained and dedicated outsourced billing staff. This increased control directly ties in with your operational benefits, which stand to benefit from outsourcing. Increased Revenues: Employing staff for billing purposes…

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  • DME Billing Services
    Updated DMEPOS Codes Fee Schedule 2019

    Updated DMEPOS Codes Fee Schedule 2019

    The Centers for Medicare & Medicaid Services (CMS) updates the DMEPOS fee schedule on an annual basis in accordance with statutes and regulations. Payment on a fee schedule basis is required for certain Durable Medical Equipment (DME), prosthetic devices, orthotics, prosthetics, and surgical dressings by Section1834 (a), (h), and (i) of the Social Security Act (the Act). Additionally, payment on a fee schedule basis is a regulatory requirement at 42 Code of Federal Regulation (CFR) Section 414.102 for Parenteral and Enteral Nutrition (PEN), splints, casts and Intraocular Lenses (IOLs) inserted in a physician’s office. The DMEPOS and PEN fee schedule files contain Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the adjusted fee schedule amounts under Section 1834(a)(1)(F) as well as codes that are not subject to the fee schedule Competitive Bidding Program (CBP) adjustments. New Codes Added New DMEPOS codes added to the HCPCS file, effective January 1, 2019, where applicable, are A4563, A5514, A6460, A6461, B4105, E0447, E0467, L8608, L8698, L8701, L8702, V5171, V5172, V5181, V5211, V5212, V5213, V5214, V5215, and V5221. The new codes are not to be used for billing purposes until they are effective on January 1, 2019. As part of this…

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  • DME Billing Services
    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule Update 2019

    CMS happen to announce in the year 2019 about Medicare fee schedule rates for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). The 2019 update factor is 2.3%, although other pricing policies are applied in specific circumstances. The DMEPOS and PEN fee schedule files contain the Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the adjusted fee schedule amounts under Section 1834(a)(1)(F) as well as codes that are not subject to the fee schedule Competitive Bidding Program adjustments. For CY 2019, the following Fee Schedule Adjustment Methodologies apply and fee schedule amounts are based on the area in which the items and services are furnished. Fee Schedule Amounts for Areas within the Contiguous United States To determine the adjusted fee schedule amounts, the average of Single Payment Amounts from CBPs located in eight different regions of the contiguous United States are used to adjust the fee schedule amounts for the states located in each of the eight regions. These Regional SPAs or RSPAs are also subject to a national ceiling 110 percent of the average of the RSPAs for all contiguous states plus the District of Columbia) and a national floor (90% of the average of the…

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  • DME Billing Services
    advantages-of-online-durable-medical-equipments-shops

    Advantages of Online Durable Medical Equipment’s Shops

    It’s estimated that even more people will opt into online durable medical equipment’s and supply for the delivery.  Since 2007, the industry has nearly doubled in size, with more people choosing it as their primary method for getting supplies; it has been witnessing a constant rise in DME billing too. The increase in in-home care has also led to more need for convenient supply access.  For many, the advantages of brick-and-mortar retailers are just too great to ignore. The industry is also set to go on growing at a six percent rate for the next couple of years. Are there any advantages to buying my medical supplies online? Well, it’s been proven that online medical supplies are not only cheaper but also in most cases more available as opposed to going around searching for a physical store that has all the products you need. DME Billing That Covers Medicare It is best to think of Medicare’s durable medical equipment coverage as having 2 levels: DME billing is covered when determined to be medically necessary and DME that is never covered despite being medically necessary. For example, grab bar rails may be completely necessary for an individual, but Medicare does not consider…

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  • DME Billing Services
    are-you-conducting-the-right-follow-up-on-all-the-dme-denied-claims

    Are You Conducting The Right Follow Up On All The DME Denied Claims?

    Getting to know the basics of denial management is vital for successfully running a medical practice and Durable medical equipment (DME) facility. Facilities that are showing positive bottom line numbers at the end of each month will generally have denial rates below 2%-3%. Also, nowadays payers are embarking system software’s so they can identify different payment procedures which apply the contract requirements. For some insurer’s, it seems that the procedure is skewed to effect denial, whenever anything is unclear. Along with this, most insurance companies expect only a fraction of DME facilities to follow-up on the claim and re-submit a corrected version. Clearly, producing clean claims saves facilities money. Indeed, even with the rising number of claims being denied all the time, DME facilities must not lose heart. There are numerous ways to answer the issue of, how to rectify increasing claim denial rates. Practices can obviously target regular zones of through where a claim denial occurs, but looking beyond the traditional norms is not just enough. Today, even a minute DME billing and coding mistake can lead to a denial or delayed reimbursement. And in such a scenario, if you are not applying the right kind follow up procedures,…

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  • DME Billing Services
    align-your-dme-billing-and-coding-priorities-with-experts-and-experience-a-profitable-income-cycle

    Align your DME Billing and Coding Priorities with Experts and Experience a Profitable Income Cycle

    Managing a Durable Medical Equipment (DME) facility is without a doubt a tough task. Right from providing patients the correct medical gear to overlooking the revenue management cycle, insurance reimbursements, along with medical billing and coding requires the help of experienced experts, be it in-house or outsourced. As a DME medical billing service provider, we know that the income cycle administration for practices has turned out to be more entangled than before. With regularly changing insurance agency norms, government regulations, compliances, and medical reforms, it has turned out to be practically impossible for DME facilities to keep up with the changing business environment. However, what this does is that it creates delayed reimbursement or denied claims, resulting in negative income cycle, and hence it becomes your top priority to align your DME billing and coding priorities with experts to experience a profitable income cycle. As one of the most prominent medical billing and coding company, catering to the US facilities our procedure is characterized is such a way that we do not miss any opportunity to increase your collection rate. Medical Billers and Coders work with a unique process workflow combined with our very own system software and technology that…

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  • DME Billing Services
    digging-deep-in-dme-coding-external-elements-that-streamline-your-medical-billing

    Digging Deep in DME coding: External Elements that streamline your Medical Billing

    Medical billing and coding from the outside may look like an easy on the run job, but it has much more intricacies that what you can imagine. The Durable Medical Equipment charges, which have different ‘codifications’, altogether are is making life worse for DME owners to sustain a streamlined revenue cycle, as most of the claims are being denied or delayed due to incorrect coding or billing information. The moot question that arises here is how can DME suppliers go to the root cause of the daily coding issues. Can they use external elements to streamline their entire billing cycle and aging AR days? Let’s find out. If you are into medical billing and coding, durable medical equipment may scare you as its coding complexities are deeply rooted in HCPCS or Healthcare Common Procedure Coding System Level II codes and Medicare’s policies. Not to worry, as there are many ways to fine-tune your DME coding abilities by digging into the DME and exploiting how to properly assign HCPCS Level II codes for billing. Firstly, one needs to start by getting their hands dirty and scooping away the top layer of DME by defining it. Next, you need to dig deeper…

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